학술논문
Estimation of central blood pressure waveform from femoral blood pressure waveform by blind sources separation.
Document Type
Academic Journal
Author
Gbaoui L; Chair of Medical System Technology, Institute for Medical Instrumentation, Otto von Guericke University, Magdeburg, Germany.; Hoeschen C; Chair of Medical System Technology, Institute for Medical Instrumentation, Otto von Guericke University, Magdeburg, Germany.; Kaniusas E; Institute of Biomedical Electronics, Vienna University of Technology (TU Wien), Vienna, Austria.; Khatib S; Department of General, Visceral-, Thoracic and Vascular Surgery, University Hospital of Ruppin-Brandenburg, Neuruppin, Germany.; Faculty of Health Sciences Brandenburg, Brandenburg Medical School Fontane, Neuruppin, Germany.; Gretschel S; Department of General, Visceral-, Thoracic and Vascular Surgery, University Hospital of Ruppin-Brandenburg, Neuruppin, Germany.; Faculty of Health Sciences Brandenburg, Brandenburg Medical School Fontane, Neuruppin, Germany.; Wellnhofer E; Institute of Computer-Assisted Cardiovascular Medicine, Charité, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Source
Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101653388 Publication Model: eCollection Cited Medium: Print ISSN: 2297-055X (Print) Linking ISSN: 2297055X NLM ISO Abbreviation: Front Cardiovasc Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2297-055X
Abstract
Background: Central blood pressure ( cBP ) is a better indicator of cardiovascular morbidity and mortality than peripheral BP ( pBP ). However, direct cBP measurement requires invasive techniques and indirect cBP measurement is based on rigid and empirical transfer functions applied to pBP . Thus, development of a personalized and well-validated method for non-invasive derivation of cBP from pBP is necessary to facilitate the clinical routine. The purpose of the present study was to develop a novel blind source separation tool to separate a single recording of pBP into their pressure waveforms composing its dynamics, to identify the compounds that lead to pressure waveform distortion at the periphery, and to estimate the cBP . The approach is patient-specific and extracts the underlying blind pressure waveforms in pBP without additional brachial cuff calibration or any a priori assumption on the arterial model.
Methods: The intra-arterial femoral BPfe and intra-aortic pressure BP ao were anonymized digital recordings from previous routine cardiac catheterizations of eight patients at the German Heart Centre Berlin. The underlying pressure waveforms in BP fe were extracted by the single-channel independent component analysis (SCICA). The accuracy of the SCICA model to estimate the whole c BP waveform was evaluated by the mean absolute error (MAE), the root mean square error (RMSE), the relative RMSE (RRMSE), and the intraclass correlation coefficient (ICC). The agreement between the intra-aortic and estimated parameters including systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and pulse pressure ( PP ) was evaluated by the regression and Bland-Altman analyses.
Results: The SCICA tool estimated the c BP waveform non-invasively from the intra-arterial BPfe with an MAE of 0.159 ± 1.629, an RMSE of 5.153 ± 0.957 mmHg, an RRMSE of 5.424 ± 1.304%, and an ICC of 0.94, as well as two waveforms contributing to morphological distortion at the femoral artery. The regression analysis showed a strong linear trend between the estimated and intra-aortic SBP, DBP, MAP, and PP with high coefficient of determination R 2 of 0.98, 0.99, 0.99, and 0.97 respectively. The Bland-Altman plots demonstrated good agreement between estimated and intra-aortic parameters with a mean error and a standard deviation of difference of -0.54 ± 2.42 mmHg [95% confidence interval (CI): -5.28 to 4.20] for SBP, -1.97 ± 1.62 mmHg (95% CI: -5.14 to 1.20) for DBP, -1.49 ± 1.40 mmHg (95% CI: -4.25 to 1.26) for MAP, and 1.43 ± 2.79 mmHg (95% CI: -4.03 to 6.90) for PP.
Conclusions: The SCICA approach is a powerful tool that identifies sources contributing to morphological distortion at peripheral arteries and estimates cBP .
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
(© 2023 Gbaoui, Hoeschen, Kaniusas, Khatib, Gretschel and Wellnhofer.)
Methods: The intra-arterial femoral BP
Results: The SCICA tool estimated the c BP waveform non-invasively from the intra-arterial BP
Conclusions: The SCICA approach is a powerful tool that identifies sources contributing to morphological distortion at peripheral arteries and estimates cBP .
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
(© 2023 Gbaoui, Hoeschen, Kaniusas, Khatib, Gretschel and Wellnhofer.)